Fetal Alcohol Spectrum Disorder and Vision
Understanding Visual Challenges in Children with FASD
- Difficulty tracking words across a page
- Trouble copying from the board or a book
- Poor hand-eye coordination affecting writing and sports
- Squinting, eye rubbing, or closing one eye
- Avoiding reading or close-up work
- Bumping into things or misjudging distances
- Short visual attention span
- Strabismus where eyes are misaligned
- Ptosis with drooping eyelids
- Small eye openings and small eyes (microphthalmia)
- Refractive errors requiring glasses
- Optic nerve hypoplasia affecting visual signals to brain
- Delayed visual maturation
- Visual processing deficits
- Behavioral and learning problems take center stage
- Visual difficulties are attributed to attention or cognitive issues
- Children cannot describe what they experience
- Standard screenings only check basic sight
Possible Causes
- Alcohol disrupts development of the eyes during pregnancy
- The optic nerve and visual pathways can be affected
- Brain areas that process vision may develop differently
- Facial and eye structure differences are common in FASD
- Eye teaming problems create double vision or visual fatigue
- Tracking difficulties make reading exhausting
- Focus flexibility issues cause strain when shifting between distances
- Visual-motor integration deficits affect coordination and handwriting
- Structural eye differences and functional vision issues often coexist
- Attention problems and visual focus deficits look identical
- Learning difficulties may be partly visual in origin
- Without comprehensive evaluation, the visual component stays hidden
The Vision Connection
- Vision accounts for 80 percent of sensory perception
- Children with FASD already face learning and behavioral challenges
- Adding visual strain makes every task harder
- The brain uses extra energy managing unreliable visual input
- Addressing vision can reduce frustration and behavioral issues
- Improved visual efficiency supports learning and attention
- Better coordination builds confidence and independence
- Other therapies work more effectively when vision is addressed
- Standard exams check eye health and clarity of sight
- Functional skills like tracking, teaming, and processing need separate testing
- Visual-motor integration is not assessed in typical screenings
- A child can see 20/20 and still have significant functional vision problems
Evaluation and Treatment
- Eye tracking and focus flexibility
- Eye teaming and alignment
- Depth perception and spatial awareness
- Visual-motor integration
- Visual processing and memory
- How vision integrates with balance and body awareness
- Individualized programs designed for each child's unique needs
- Treatment adapted to work with attention and behavioral patterns
- Activities structured to maintain engagement
- Neuro-visual performance training builds new brain pathways
- Intensive in-office programs with remote follow-up
- Occupational therapy gains stronger visual-motor foundations
- Speech and language work benefits when visual attention improves
- Behavioral interventions work better when visual frustration decreases
- Educational accommodations become more effective
Questions and Answers
Vision problems are very common in children with FASD. Studies suggest over 90 percent have some form of visual or eye abnormality. These range from structural differences to functional vision deficits. Comprehensive vision evaluation is recommended for all children with FASD.
Vision therapy cannot repair structural damage to the optic nerve. However, it can help maximize the visual function your child has by strengthening tracking, teaming, and processing skills. Many children with optic nerve differences still benefit from functional vision support.
It may be both. Attention difficulties are common in FASD, but visual focus problems can look identical. A developmental vision evaluation can identify the visual component. Addressing vision does not cure FASD attention issues but can remove an additional barrier to focus.
Reading requires smooth eye tracking, stable eye teaming, and efficient visual processing. If any of these skills are weak, reading becomes exhausting regardless of intelligence. Addressing functional vision issues can make reading less effortful and more successful.
NVPI has over 40 years of experience with children who have behavioral and attention challenges. Sessions are structured to maintain engagement. Activities are adapted to each child's needs. The team understands that behavior often improves when underlying frustrations are addressed.
Many children with FASD do need glasses to correct refractive errors. However, glasses alone do not address functional vision skills like tracking and teaming. Vision therapy builds these abilities. Glasses and vision therapy often work together as part of a complete treatment plan.
We saw a huge improvement in reading comprehension, balance, coordination and quite a few other things. We found out that a lot of the anxiety and confidence issues that our son had dealt with for years were directly tied to his vision struggles. This was a huge surprise to us. Very glad we found our way to Dr Graebe and his team.
Bryan Cox
Wonderful institute, friendly staff and efficient therapy methods. Therapists take extra time to work individually with you to help meet your goals. Would recommend to anyone!
Braden Baker
I had been to several eye doctors who underestimated the problems I had started to have with my vision. Speaking with Dr Graebe gave me such hope. He not only listened to me but help set a course for my healing.. I’ve noticed a lot of improvement and am still working towards my goal.
Amanda Sears
Dr. Graebe and his staff are absolutely wonderful. I have seen so many improvements in my day to day life. My issues presented after I had PRK eye surgery and no longer wore corrective lenses. The surgery gave me 20/15 vision. Now my anxiety is completely gone, I’m back in college with excellent grades, I love driving again, and my coordination is back. Those are just some of the improvements. Dr. Graebe did a wonderful job helping me. I’ve seen some amazing results!
Chase Centers
Dr. Graebe is a doctor whose passion for his job is evident the moment you meet him. He truly cares and is incredibly knowledgeable! 🙏1
Ashlie Fraley
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